Angifibroma juvenile — evolution of surgical management
Journal Title: Otolaryngologia Polska - Year 2011, Vol 65, Issue 5
Abstract
SUMMARY Introduction: Juvenile Angiofibroma has been challenged generations of surgeons. The problem is, not only in specific clinical features of the tumour, but also in difficult surgical approach to anatomical area in which it is located. was to analyze development of surgical techniques in treatment of juvenile angiofibroma and potential conditions which influence on therapy results. Materia! and method: The retrospective study that analyzes 47 juvenile angiofibroma cases, which were treated in the Otorhinolaryngology Depart-ment of Warsaw Medical University in years 1980-2010. Results: The five surgical approaches were used in the group of patients, filled in this study. The use of midfacial degloving has become increasingly popular, replacing lateral rhinotomy and transpalatal approach, which were commonly used in early nineties of the last century. The infratem-poral approach was used in one case of disease with parapharyngeal and infratemporal extension. One of the recent patients was treated, first time in history of the Department, using endoscopic approach. The routine protocol of treatment includes preoperative CT and MRI and angiography with embolization of the main tumour vessels. The gradual, but consequent improvement in therapy results is revealed as reduction of recurrence from 35% to 20%. Conclusions: In therapy of juvenile angiofibroma become popular surgical techniques, which are not connected with visible scars and which reduce tissue trauma in operated area. Besides mastering surgical skills, the independent condition, which improves therapy results, is using modern diagnostic and therapeutic procedures. They contribute to better assessment of tumour location and extension, and reduction of intraoperative blood loss.
Authors and Affiliations
Jarosław Balcerzak, Tomasz Gotlib, Magdalena Hamera, Ewa Osuch-Wójcikiewicz, Kazimierz Niemczyk
Keywords
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